Overview and Advantages
Lipofilling, or fat grafting, is an established technique that has seen a resurgence over the past decade, particularly in breast reconstruction and facial rejuvenation. It provides a natural alternative to breast implants, using the patient’s own fat to restore volume and shape. This procedure is especially suitable for women seeking a more organic, harmonious reconstruction after breast cancer surgery.
Fat Injection: Principles and Technique
The process begins with liposuction, where fatty tissue is gently harvested from areas such as the abdomen, thighs, or flanks. The fat is then purified to remove blood, excess fluid, and damaged fatty tissue using one of two methods:
- Centrifugation (Coleman technique) – Ideal for small-volume grafting, particularly in facial procedures.
- Puregraft® filtration system (Cytori) – Preferred for large-volume fat transfers such as breast or buttock reconstruction.
Once purified, the fat is re-injected into the recipient area using ultra-fine cannulas. This constitutes a true adipocyte graft, with a portion of the transferred fat becoming permanently integrated as living tissue.
Note: Around 20–30% of the injected fat is naturally reabsorbed in the first two months. However, once integrated, the remaining fat is stable and long-lasting.
Indications for Breast Lipofilling
Breast fat injection can be used in the following cases:
- Aesthetic breast augmentation, achieving a 1-cup size increase with 1–2 sessions (approx. 200cc volume)
- Camouflage of visible breast implants (e.g. rippling or contour issues)
- Correction of breast deformities including:
- Breast asymmetry
- Tuberous breasts
- Poland syndrome
- Post-lumpectomy or radiotherapy reconstruction (after a 5-year cancer remission)
- Volume enhancement following the dorsalis major flap reconstruction (without an implant)
Procedure in Practice
- Anesthesia: Typically performed under general anesthesia. Small-volume transfers may be done under local anesthesia with sedation (neuroleptanalgesia).
- Outpatient or Overnight Stay: Most procedures are outpatient, but some cases require an overnight stay for monitoring.
- Preoperative Instructions:
- Avoid aspirin and anti-inflammatory medications 10 days before surgery.
- Stop smoking at least 1 month before and after surgery to improve fat graft viability.
- Postoperative Care:
- Wear a compression garment continuously for 1 month in the harvesting area.
Use compression stockings for 1 week following the procedure.
Questions and Answers
What are the risks of breast fat injection?
Complications are rare, but can include:
- Infection from necrotic fat (occurs in <2% of cases)
- Fat reabsorption cysts (cytosteatonecrosis), which may be palpable under the skin
- Liposuction-related issues: phlebitis, asymmetry, or surface irregularities
Does the fat remain stable over time?
Yes. Once the grafted fat has integrated (typically by 1 month), it remains stable long-term, unlike hyaluronic acid fillers, which are absorbed over several months.
Are there follow-up imaging requirements?
Yes. A digital mammogram and MRI are typically recommended 3 months after the procedure. These serve as a baseline for future breast cancer screenings.
How many sessions are required?
On average, 2 to 3 sessions are needed to achieve optimal volume and shape.
Cost and Reimbursement
- Medical Indications (e.g. post-cancer reconstruction or malformation):
Covered by French social security, with additional fees ranging from €1,500 to €2,000, depending on volume. - Aesthetic Breast Augmentation:
Each session costs from €6,500 to €8,000, with 1–2 sessions typically needed for a one-cup increase.
If you have any questions or would like to schedule a consultation, please don’t hesitate to contact our team.